Individual
WANDA BLAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 ROSEMEADE PKWY APT 812, DALLAS, TX 75287-2921
(214) 283-0892
Mailing address
4300 ROSEMEADE PKWY APT 812, DALLAS, TX 75287-2921
(214) 283-0892
Taxonomy
Speciality
Code
Description
License number
State
2278G1100X
General Care Certified Respiratory Therapist
Primary
62660
TX
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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